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H5N1 Fatality in Fayoum Egypt Raises Concerns Recombinomics Commentary 17:30
March 4, 2008
The case is a 25 years old female from Sennoris District, Fayum Governorate. She developed symptoms on 24 February and was hospitalized on 27 February. Her death has now been confirmed by the Ministry of Health and Population.
The above comments from the most recent WHO update are not a surprise. H5N1 in Egypt appears to be more aggressive this year. A year ago there was an increase in H5N1 cases in March and April, but the vast majority of the cases were mild. Only one in seventeen were fatal, and most did not develop pneumonia.
The above case developed pneumonia in both lungs, even though she was hospitalized three days after disease onset. However, she was in critical condition and most H5N1 cases in critical condition do not survive. However, the update fails to mention the hospitalization of the sister of the fatal case or the confirmation of a third case in Egypt in just over a week.
Recently released sequences from poultry in Egypt signals a failed vaccination program, and a rapid evolution of H5N1, including many isolates with the receptor binding domain change of M230I or M230V.
The rapid evolution of H5N1 in Egypt, coupled with more aggressive human cases, is cause for concern.
Release of human sequences from the eight confirmed cases this season, including the five at the end of last year, as well as NA sequences from recent poultry isolates would be useful.
.
"The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation
Confirmed H5N1 in Minufiyah Egypt Raises Concerns Recombinomics Commentary 18:20
March 4, 2008
In a separate statement, the ministry said an 11-year-old boy from the Nile Delta province of Menoufia had tested positive for the virus after entering a local hospital on Feb. 26.
The woman and the boy, named as Mohamed Rabie Mohamed Abdel Halim, are thought to have come into contact with sick birds
The above comments describe the third confirmed H5N1 in Egypt in just over a week. The cases were in separate governorates and signal the start of the spring season, when H5N1 cases peak. However, the cases this spring appear to be more aggressive.
The first case (4F) is stable, but had developed pneumonia in at least one lung. The second case (25F) developed pneumonia in both lungs, and has died. The status of the above case is not described, but last year at this time the cases were concentrated in upper Egypt and were mild.
The cases this season, including the five confirmed cases at the end of 2007, were large concentrated in the north. Many of the recent sequences published by national veterinary labs or NAMRU-3 have been from the north and have a large number of non synonymous changes, including M230I and M230V. Last season, all patients with M230I died.
Sequence data from the recent cases, and NA sequences from the recent poultry isolates would be useful.
.
"The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation
Pneumonia in H5N1 Patients in Egypt Recombinomics Commentary 21:13
March 4, 2008
The Ministry of Health of Egyptian human infection No. 46 avian influenza illness of a child age 11 in the village of dams Menoufiya Governorate.
The ministry said in a statement today that the situation has entered a hospital salt worries on February 26 last to suffer from high temperature and shortness of breath and pneumonia
The above translation indicates the most recent confirmed H5N1 case in Egypt has developed pneumonia. Thus, all three confirmed Egyptian cases in the past week have been more severe than the cases at this time last year.
Last year, the H5N1 sequences in the south were markedly different than the sequences in the Nile Delta. One change, M230I, was widespread in the north, and all patients with M230I died. This year the recently released poultry sequences indicated M230I and M230V are widespread, especially in the north.
Moreover, the recent sequences have a large number of non synonymous changes, which may be associated with a more aggressive H5N1. At the end of 2007 there were five confirmed cases. Four of the five died, but the H5N1 sequences have not been released..
The situation in Egypt is growing more serious. There have been three confirmed pneumonia cases in a week. None of the patients have been discharged and one has died.
The sequence data from vaccinated flocks signal significant problems, and the WHO report on vaccine selection fails to appreciate the degree of heterogeneity in Egypt or the rapid H5N1 evolution. The sequences from the Gharbya cluster are not only not targeted, they are not included in the phylogenetic tree in the report.
Release of the human H5N1 sequences as well as the NA sequences from the poultry isolates would be useful.
.
"The next major advancement in the health of American people will be determined by what the individual is willing to do for himself"-- John Knowles, Former President of the Rockefeller Foundation
Egyptian wounded child reaches the age of 11 years avian influenza
أعلنت وزارة الصحة المصرية امس الثلاثاء/4 مارس الحالي/ عن إصابة طفل يبلغ من العمر 11 عاما بمرض انفلونزا الطيور ليصل بذلك اجمالى المصابين بهذا المرض فى مصر إلى 46 شخصا.
The Ministry of Health yesterday, Tuesday, the Egyptian / current March 4 / injury to a child reaches the age of 11 years contracted bird flu, bringing the total infected in Egypt to 46 people.
وذكرت الوزارة فى بيان صحفى صدر اليوم أن الطفل محمد ربيع البالغ من العمر 11 عاما من محافظة المنوفية شمال العاصمة المصرية القاهرة اصيب بانفلونزا الطيور بسبب تعرضه لطيور يشتبه فى اصابتها بالمرض.
The ministry said in a press statement issued today that the child Mohammed Rabie 11-year-old from Menoufiya Governorate north of the Egyptian capital Cairo injured bird flu because he was suspected of being infected with bird disease.
وتعد هذه الحالة البشرية الثالثة التى اصيبت بالمرض فى خلال اسبوع تقريبا، حيث أعلنت وزارة الصحة المصرية عن اصابة طفلة مصرية تبلغ من العمر اربع سنوات بانفلونزا الطيور فى الاول من مارس الحالى وقبلها بايام قليلة اصيبت فتاة فى العشرينيات من عمرها بنفس المرض.
This is the third case of human disfigurement that the disease within a week ago, where the Ministry of Health in Egypt Egyptian injured girl, aged four years avian influenza in the first of March, a few days before the girl was in Morocco the same old disease.
وتعتبر مصر من أكثر الدول اصابة بمرض انفلونزا الطيور الذى أدى إلى وفاة 19 شخصا من إجمالي 46 مصابا.
Egypt is the most cases of avian influenza, which led to the death of 19 persons of the total 46 injured.
ويرجع تزايد عدد المصابين بمرض انفلونزا الطيور فى مصر إلى وقوعها على طريق الطيور المهاجرة وانتشار تربية الدواجن فى المنازل، وهو ما يفسر أن أكثر الذين لقوا حتفهم جراء المرض من النساء والأطفال.
Because of the increasing number of people diagnosed with bird flu in Egypt to occur on the path of migratory birds and the spread of poultry in homes, which explains that most of those who died of the disease are women and children.
اعلنت وزارة الصحة عن وفاة الحالة البشرية رقم 20 مصابة بمرض إنفلونزا الطيور فى 4/3/2008 وهي سيدة 25 سنه دخلت مستشفى حميات الفيوم ثم تم تحويلها الى مستشفى صدر الجيزة وهى تعانى من ارتفاع فى درجة الحرارة وضيق بالتنفس والتهاب رئوى والان بالجسم عقب تعرضها لطيور مصابة بمرض انفلونزا الطيور وتم اعطائها العلاج اللازم وتم عمل التقصى الوبائى لجميع افراد الاسرة وجميع المخالطين للحالة واثبتت المتابعة عدم اصابة اى منهم بالمرض .
The Ministry of Health announced the death of the human condition No. 20 infected with avian influenza disease in 4/3/2008 a lady 25 years entered the hospital salt Fayoum was then transferred to a hospital Giza is suffering from high temperature and narrow breathing and pneumonia, and now body after exposure to infected birds contracted avian influenza have been given the necessary treatment was working Epidemiological Investigation of all family members and all contacts of the situation and follow-up proved to be infected with any of them the disease.
كما أعلنت وزارة الصحة عن الإصابة البشرية رقم 46 بالمرض لطفل 11 سنة من قرية سدود بمركز منوف بمحافظة المنوفية دخل مستشفى حميات منوف وهو يعانى من ارتفاع فى درجة الحرارة وضيق بالتنفس والتهاب رئوى وتم تحويلة لمستشفى منشية البكرى بالقاهرة ولا يزال يتلقى العلاج .
It also announced that the Ministry of Health on the incidence of human disease No. 46 for a child 11 years old from the village of dams status worries Menoufiya Governorate entered hospital salt worries He suffers from high temperature and narrow breathing and pneumonia were transferred to a hospital in Cairo Adviser Bakry is still receiving treatment .
ما زال فيروس أنفلونزا الطيور يمثل لغزاً يصعب حله في مصر حتى الآن..
Still the bird flu virus is a mystery difficult to resolve in Egypt so far ..
وعلى الرغم من الإجراءات الاحترازية التي تتخذها وزارة الصحة والهيئات المعنية لمكافحة الفيروس القاتل، إلا أنه يمارس هوايته المفضلة وينشر الرعب والفزع بين المصريين، ويثبت للجميع أنه مازال متوطنا في البلاد .
In spite of the precautionary measures taken by the Ministry of Health and relevant bodies to combat the deadly virus, but he exercised his hobby of choice and spreads terror and panic among Egyptians, and prove to everyone that he was still endemic in the country. <O:P></O:P>
<O:P></O:P>
ووسط جو يسوده الترقب والحذر بسبب الإصابات المتكررة وحالات الوفاة المتزايدة التي سجلت بمصر في الفترة الأخيرة، والتي كان آخرها الإصابة البشرية رقم 45 بالفيروس، أعلنت وزارة الصحة المصرية عن وفاة امراة في الخامسة والعشرين من العمر بفيروس "اتش5 ان1" في محافظة الفيوم جنوب القاهرة لتصبح الضحية العشرين لهذا الفيروس القاتل منذ ظهوره في مصر في فبراير 2006.
Amid an atmosphere of anticipation and caution because of repeated injuries and deaths registered in Egypt increased in the recent period, the latest of which was No. 45 human infection with HIV, the Ministry of Health in Egypt for the deaths of women in the twenty-fifth-old HIV "Watch 5 to 1" in the province of Fayoum south of Cairo to read Twenty victim of this deadly virus since its emergence in Egypt in February 2006. <O:P></O:P>
<O:P></O:P>
واوضحت الوزارة في بيان لها أن سوزان علي صلاح ذكى 25 سنة توفيت في مستشفى الصدر بالجيزة الذي نقلت اليه في 28 فبراير الماضي وهي "تعاني من ارتفاع فى درجة الحرارة وضيق بالتنفس والتهاب رئوى وآلام بالجسم عقب تعرضها لطيور مصابة بمرض انفلوانزا الطيور.
The ministry said in a statement on the Susan Salah intelligent 25-year-Sadr died in a hospital in Giza, which quoted him in February 28 last is "suffering from high temperature and narrow breathing and pneumonia, and the mother body following exposure to infected birds contracted bird flu. <O:P></O:P>
<O:P></O:P>
من جهة أخرى، أعلنت الوزارة عن إصابة الحالة البشرية رقم 46 بمرض أنفلونزا الطيور وهي لطفل في الـ 11 من عمره في احدى قرى محافظة المنوفية.
In addition, the ministry on the situation of human infection No. 46 contracted avian influenza is of a child in the 11-year-old in one of the villages of Al-Menoufiya. <O:P></O:P>
<O:P></O:P>
وأوضح بيان لوزارة الصحة أن الطفل محمد ربيع البالغ من العمر 11 عاما تم ايداعه في مستشفى الحميات بالمحافظة في الـ26 من فبراير الماضي وهو يعاني ارتفاعا في درجة الحرارة وضيقا في التنفس والتهابا رئويا عقب تعرضه لطيور يشتبه باصابتها بالمرض، وتم اعطاء الطفل عقار "التاميفلو" بعد الاشتباه باصابته بالمرض وتم تحويله الى أحد مستشفيات القاهرة لاستكمال علاجه به.
A statement by the Ministry of Health that the child Mohammed Rabie 11-year-old was placed in a hospital dietary preservation in the 26 last February and is now in a rise in temperature and a narrow breathing, it ignites Rauia after being infected birds suspected safety, and give the child the real estate "Tamiflu ®" after suspicion affect the disease was transferred to a hospital in Cairo to complete the treatment. <O:P></O:P>
<O:P></O:P>
يأتي ذلك بعد يومين من إعلان وزارة الصحة عن الاصابة البشرية رقم 45 بمرض انفلونزا الطيور، وهي لفتاة في الـ25 من عمرها من احدى قرى محافظة الفيوم جنوبي البلاد.
This comes two days after the announcement of the Ministry of Health for human infection No. 45 contracted avian influenza, a girl in the 25-year-old girl from a village in Fayoum governorate, south of the country. <O:P></O:P>
<O:P></O:P>
وأوضح عبدالرحمن شاهين المتحدث الرسمي لوزارة الصحة والسكان أن المصابة دخلت مستشفى حميات الفيوم الاربعاء الماضي وهي تعاني ارتفاعا في درجة الحرارة وضيق في التنفس والتهاب رئوي وآلام بالجسم عقب تعرضها لطيور يشتبه في اصابتها بمرض انفلونزا الطيور.
The Abdulrahman Shaheen Spokesman of the Ministry of Health and Population to infected entered the hospital last Wednesday salt Fayoum is experiencing a rise in temperature and shortness of breath, pneumonia and the mother body following exposure to birds suspected of being infected with bird flu disease. <O:P></O:P>
<O:P></O:P>
وأضاف أنه تم إحالة الفتاة الى مستشفى صدر الجيزة واعطائها عقار "تاميفلو" فور الاشتباه في إصابتها بالمرض وهي الآن على جهاز التنفس الصناعي ويتم حاليا متابعة حالتها وتوفير الرعاية اللازمة لها.
He was referring girl to the hospital was Giza and giving drug "Tamiflu" as soon suspected of carrying the disease and is now on a breathing industrial and is currently condition and follow-up care required. <O:P></O:P>
<O:P></O:P>
وكان وزير الدكتور حاتم الجبلي الصحة والسكان المصري قد ذكر أن نسبة الاصابة بمرض انفلونزا الطيور بمصر أقل من النسبة العالمية، معتبرا أنها تحتل المركز الثالث حاليا في قائمة الدول التي أصيبت بمرض انفلونزا الطيور بعد اندونيسيا وفيتنام.
The Minister of Health Dr. Hatem mountain and the population of Egypt has stated that the incidence of avian influenza disease in Egypt less than the global figure, considering that it currently occupies third place in the list of countries hit by bird flu disease after Indonesia and Vietnam. <O:P></O:P>
وعن خطورة المشكلة، قالت الدكتورة منى محرز رئيس المعمل القومى للرقابة على الانتاج الداجنى، في تصريحات لـ"محيط" ان خطر انفلونزا الطيور مازال قائما ومن الممكن ان يعود بنفس القوة التى كان عليه فى بداية ظهورها خاصة ان الاعلام المصرى لم يعد يقوم بالدور المطلوب منه على النحو الامثل مما دفع المواطنين ان يتناسوا خطورة المرض على الرغم من الخسائر المادية والبشرية التى لحقت بهم.
And the seriousness of the problem, said Dr. Mona Mehrez President of the National Laboratory of the control of poultry production, told "perimeter" that the risk of avian influenza virus is still present it is possible to return the same force that it was in the beginning appear especially Egyptian media no longer play the role required of it as optimal, which prompted citizens to forget the seriousness of the disease despite the material and human losses caused to them.
<O:P></O:P>
ووصفت الدكتورة منى محرز الشعب المصرى بالشعب الطيب الذى ينسى بسرعة حتى لو كان ذلك على حساب صحتهم متهمة اصحاب المزارع بالتقصير لانهم لم يقوموا باتباع وسائل الامان الحيوى لمواجهة المرض.
She described Dr Mona Mehrez Egyptian people, the good people forget so quickly if it was to the detriment of their health Accused plantation owners default because they did not play a vital security measures to counter the disease. <O:P></O:P>
<O:P></O:P>
وفي الوقت نفسه، اعترف الدكتور حامد سماحة رئيس الهيئة العامة للخدمات البيطرية ان الهيئة لم تقوم بانجاز مهامها فى تطعيم جمبع الدواجن فى المزارع فلم يتم سوى تطعيم 60%من المزارع أما باقى المزارع لم يتم تحصينها ، لافتا الى ان الهيئة قامت بتوفير اكثر من 75 مليون مصل لبدء المرحلة الثانية من التطعيم خاصة ان هذة المرحلة من اهم المراحل لان الفيروس ينشط فى فصل الشتاء .
At the same time, admitted Dr. Hamid Samaha Chairman of the General Authority for Veterinary Services that the Commission did not complete the tasks to vaccinate all poultry farms had been vaccinated only 60% of the farms As for the rest of the farms have not been vaccinated, pointing out that the Commission has provided more than 75 million vaccine to begin the second phase of vaccination that this particular phase of the most important stages, because the virus is active in the winter. <O:P></O:P>
يؤكد خبراء الصحة أن مرض انفلونزا الطيور ينتقل بين الطيور عن طريق البراز والرذاذ الناتج من افرازات الأنف والعين وكذلك تلوث المعالف والمساقي والمعدات والملابس داخل المزرعة بهذه الافرازات وكذلك تتم العدوى في فقاسات البيض عندما يتم انكسار بيض مصاب بالفيروس.
The health experts that the bird flu spread from birds through feces and droplets resulting from the nose and eye secretions as well as pollution Mangers and canals, equipment and clothing within the farm these secretions, as well as infections are in Faqasat eggs when Daylight eggs infected with the virus. <O:P></O:P>
<O:P></O:P>
ويمكن انتقال المرض من خلال الطيور المهاجرة ولكن بنسب ضعيفة حيث أن الطيور المصابة غالبا ما تكون في حالة اعياء شديد يصعب الطيران لمسافات طويلة والفيروس يتأثر بالحرارة والمطهرات، فيثبط عند درجة 60 لمدة نصف ساعة وكذلك بالمطهرات مثل الفورمالين ومركبات اليود.
The transmission of the disease through migratory birds, but rates low where infected birds are often in the case of fatigue very difficult to fly long distances and the heat affected by the virus, disinfectants, Vithbt at 60 degrees for half an hour, as well as disinfectants such as iodine Formalin and vehicles. <O:P></O:P>
<O:P></O:P>
ويمكن للفيروس الانتقال إلى الإنسان -خاصة المتعاملين في مجال الدواجن سواء بالتربية أو البيع- عن طريق التلامس مع افرازات الطيور أو البراز، ولكن حتى الآن لم يثبت انتقال المرض من إنسان إلى آخر حسب النتائج الناجمة عن الاختبارات التي أجرتها منظمة الصحة الحيوانية، كما أن الدجاج المطبوخ جيداً لا يمكن ان يتسبب في نقل المرض نظرا لتأثير الحرارة على الفيروس كما سبق.
The transition of the virus to humans - particularly those dealing in the area of education or whether poultry sales - through contact with bird droppings or feces, but so far failed to prove transmission of the disease from person to another according to the results of the tests conducted by the Organization for Animal Health, and the chicken well-cooked can cause the transfer of the disease due to the impact of temperature on the virus as previously. <O:P></O:P>
<O:P></O:P>
وحسب تقارير المنظمات ذات الصلة فإن معظم الاصابات التي تم تشخيصها حتى الآن ظهرت لدى المتعاملين في تربية الدواجن والعاملين في المسالخ..
According to reports relevant organizations, the majority of casualties that have been diagnosed so far appeared to dealers in the poultry and working in abattoirs ..
لكن بالرغم من ذلك فإنه لا يزال من الصعب انتقال عدوى انفلونزا الطيور التي وصلت مؤخرا الى القارة الاوروبية من الطيور المصابة الى الانسان لكنها تثير المخاوف من انتشار وباء يصعب السيطرة عليه بوسائل الحماية الحالية.
However, it is still difficult infected with avian influenza, which arrived recently to the European continent from infected birds to humans but raise fears of an epidemic is difficult to control through current protection.
Bird flu kills Susan affects children [child] in one day
Tarek wrote Amin Mohamed Farghali
5/3/2008
Harvesting of the bird flu virus new human victim, yesterday, which brings the number of deaths to 20 since the disease Egypt mid-February 2006, at a time when increased number of cases of human infection causing the disease to 46 case after case of the emergence of new positive yesterday.
The Ministry of Health and Population on the death of Susan Salah Zaki 25 years Hospital issued Giza, which had been receiving treatment for the disease when the killer, and a statement that the ministry infected died from discontinued heart after working several attempts to revive the heart and respiration.
The deceased - housewife from the village of gunshot status Brenda - have introduced salt Fayoum Hospital on February 27 last, and was transferred to a hospital in Giza next day.
The statement also injured child Mohamed Rabia Mohammed Abdulhamid 11 year», from the village of dams Center worries Al virus, and was transferred to a hospital Adviser Bakry [that's the children's hospital - T42] currently receiving treatment.
To the present, the hospital dietary and chest in a large number of provinces, yesterday, the detention of dozens of cases suspected of carrying avian influenza.
أ ش أ - أعلنت وزارة الصحة والسكان اليوم الثلاثاء عن إصابة الحالة البشرية 46 بمرض أنفلونزا الطيور منذ ظهوره أوائل عام 2006وهى من قرية سدود مركز منوف محافظة المنوفية للطفل محمد ربيع محمد عبدالحليم.
MENA - The Ministry of Health and Population today, Tuesday, injuring 46 human case of avian influenza since the disease first appeared in 2006, one of the village dams worries Al status of the child Muhammad Muhammad Abdulhamid spring.
أوضح بيان صادر عن وزارة الصحة اليوم أن الطفل محمد ربيع (11 عاما) دخل مستشفى حميات منوف يوم الثلاثاء 26 فبراير الماضى وهو يعانى من ارتفاع فى درجة الحرارة، وضيق فى التنفس، والتهاب رئوى عقب تعرضه لطيور يشتبه فى اصابتها بالمرض.
A statement issued by the Ministry of Health today that the child Mohammed spring (11 years old) entered the hospital salt worries on Tuesday February 26 last He suffers from high temperature and shortness of breath, and pneumonia after being afflicted birds suspected of carrying the disease.
ذكر البيان أنه تم اعطاء الطفل عقار التاميفلو فور الإشتباه فى اصابته بالمرض وتم تحويله إلى مستشفى منشية البكرى بالقاهرة التى يستكمل علاجه بها حاليا.
The statement said that it had been giving the child drug Tamiflu ® immediately suspected of being infected were transferred to a hospital in Cairo that Menasheh Bakri completed cured by now.
5 March 2008
The Ministry of Health and Population of Egypt has announced a new human case of avian influenza A(H5N1) virus infection. The case is an 11-year-old male from Menof District, Menofia Governorate. He was hospitalized with symptoms on 26 February and was confirmed as being infected with A(H5N1) by the Central Public Health Laboratory and NAMRU-3 on 4 March. He remains in a critical condition.
Investigations into the source of his infection indicate a history of contact with sick and dead poultry.
Of the 46 cases confirmed to date in Egypt, 20 have been fatal.
?Bird flu? kills ?Susan? affects children in one day
Tarek wrote Amin Mohamed Farghali 5/3/2008
Son of the deceased and her father
Harvesting of the bird flu virus new human victim, yesterday, which brings the number of deaths to 20 since the disease Egypt mid-February 2006, at a time when increased number of cases of human infection causing the disease to 46 case after case of the emergence of new positive yesterday.
The Ministry of Health and Population on the death of Susan Salah Zaki ?25 years? Hospital issued Giza, which had been receiving treatment for the disease when the killer, and a statement that the ministry infected died from discontinued heart after working several attempts to revive the heart and respiration.
The deceased - housewife from the village of gunshot status Brenda - have introduced salt Fayoum Hospital on February 27 last, and was transferred to a hospital in Giza next day.
The statement also injured child Mohamed Rabia Mohammed Abdulhamid ?11 years?, from the village of dams Center worries Al virus, and was transferred to a hospital Adviser Bakry currently receiving treatment.
To the present, the hospital dietary and chest in a large number of provinces, yesterday, the detention of dozens of cases suspected of carrying avian influenza.
?Bird flu? kills ?Susan? affects children in one day
To the present, the hospital dietary and chest in a large number of provinces, yesterday, the detention of dozens of cases suspected of carrying avian influenza.
Does the above indicate there are currently dozens of hospitalized suspect cases, or simply indicate that cummulatively, the hospital has treated dozens of suspect cases?
Does the above indicate there are currently dozens of hospitalized suspect cases, or simply indicate that cummulatively, the hospital has treated dozens of suspect cases?
I have forwarded this question to a contact there who speaks fluent Egyptian arabic.
Does the above indicate there are currently dozens of hospitalized suspect cases, or simply indicate that cummulatively, the hospital has treated dozens of suspect cases?
It's not 100% clear to me, but I'm leaning toward the interpretation that they're saying that currently there are tens or dozens of suspected cases in hospitals all across Egypt (not just this one hospital).
Here's an alternative machine-translation to the Google one:
To this, the hospitals of fevers and chest continued in a big number of [i.e. many] governorates, yesterday, the detention of tens of the cases that are suspected their injury by the bird flu.
That's not surprising, though. We just saw the other day that there were 620 suspected cases in Egypt in the 6 weeks between Jan 17 - Feb 27. That's prolly tens or dozens at any given time.:
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